Key result
An otherwise healthy 25-year-old man was incidentally found to have a Brugada type-1 ECG pattern and an Epsilon-like wave, highlighting the importance of careful follow-up and electrophysiology study.
Why the study?
Comprehending the electrocardiographic features of Brugada Syndrome and arrhythmogenic right ventricle dysplasia is crucial because they are rare cardiomyopathies predisposing to sudden cardiac death.
Case Report (n=1)
No
This case highlights the incidental finding of a Brugada type-1 pattern with an Epsilon-like wave in an asymptomatic patient, emphasizing the need for electrophysiology study as per ESC guidelines.
Background: Brugada Syndrome (BrS) and arrhythmogenic right ventricle dysplasia (ARVD) are rare cardiomyopathies predisposing to sudden cardiac death (SCD). Comprehending the electrocardiographic features of these cardiomyopathies are crucial especially in emergency settings.Case presentation: A 25-year old medical student presented with no complaints, but had episodes of syncope, chest pain, and palpitations of unknown origin 10 years ago. The initial assessment showed stable hemodynamics. During examination, the ECG demonstrated incomplete right bundle branch block, Brugada-type 1 pattern, with signs of Epsilon wave. The following year, assessment of the ECG was repeated and findings were found suggestive of Brugada syndrome, although his echocardiography showed no structural abnormality. According to ESC guidelines, asymptomatic Brugada patients should undergo electrophysiology study.Conclusion: Careful follow-up with electrophysiology study is recommended for this patient in order to identify the likelihood of true Brugada and suitability for radiofrequency ablation or implantation of implantable cardioverter defibrillator (ICD).
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Mendel et al. (2022) conducted a case report in Brugada Syndrome and Epsilon-Like Pattern (n=1). Electrocardiography was evaluated on ECG abnormalities. An otherwise healthy 25-year-old man was incidentally found to have a Brugada type-1 ECG pattern and an Epsilon-like wave, highlighting the importance of careful follow-up and electrophysiology study.
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